Medical-only claim
A medical-only claim is one where an injured worker received treatment but never missed work: no lost time, no indemnity payments, just medical bills. Many state rating plans apply a reduced weight to medical-only claims when calculating your EMR (experience modification rate), on the theory that a claim with no lost time is less predictive of future risk than one with lost time. Where a state has adopted NCCI's Experience Rating Adjustment, a medical-only claim counts at only 30% of its primary and excess losses, a 70% reduction, though not every state has adopted this adjustment. Whether it applies to your state, and whether it was actually applied to every eligible claim on your worksheet, is worth checking specifically, since a medical-only claim valued as if it were a lost-time claim can meaningfully inflate a mod without anyone noticing. The distinction turns entirely on lost time, not on how serious the treatment sounds, so a claim with significant medical bills but no missed work still qualifies as medical-only.
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